[Music] [Music] Hello friends today we are going to discuss about IQ assessment as per the recent gazed notification 2024 I'm Dr Sur badmat professor of Psychiatry working at National Institute of Mental Health and neuros sensus Bangalore in this video I'll be discussing about the recent Gazette notification which was done on 12th March 2024 regarding IQ assessment in this Gazette notification they have discussed what are the tools to be used how to use and when to use I'll also be discussing about what are the positive aspect and negative aspect of this Gazette notification as I mentioned on 12th March 2024 the government of India came up with a recent new guidelines for assessment of disability in this regard for developmental disorder a subcommittee was also formed under the chairman of Dr shifali gulati she is the child neurologist and a professor working at Department of Pediatrics Ames New Delhi in the whole the gazet notification they came up with the list of tools which can be used for rpwd act for the assessment of disability they also mentioned what are the tools which are available freely and which are copyrighted and this notification was done under the right to persons with Disability Act of 2016 with regard to IQ test which is mentioned in the page number 522 and 523 I am here giving page number for simple reasoning is it is around 800 plus pages of notification that means you have to sit and search where is this IQ test how to do it and where you have to find hence I'm giving the page numbers they have mentioned certain set of tools with regard to IQ test they have come up with vsms which is winland social maturity scale which is copyrighted the next one is melin intelligence scale for Indian children again it is a copyrighted the next three which talks about vular scale for children Edition 4 again a copyrighted bamat test again copyrighted the only one which is not copyrighted is nipd IQ test which is freely available that means they have named five IQ test which can be used for assessing disability with regard to of iqq test that means intellectual disability with regard to sld there are two important tools have been named one is Nan's index for sld which is copyrighted the second one is grade level assessment device for children with learning problems in school it is called as glad which is freely available but unfortunately the assessment of sldd is for till the standard fourth standard only similarly with regard to autism they have mentioned about inclan diagnostic tool for ASD and Indian scale for assessment of autism which are freely available and finally ideas for mental illness now let's discuss about intellectual disability as per this Gazette notification page number 489 intellectual disability is defined as a condition characterized by significant limitations both in intellectual functioning that is reasoning learning problem solving and in adaptive Behavior with onset in the developmental period and which covers a range of daily social skills and skills required for activities of daily living they have given this definition to clarify the term intellectual disability will be reserved for children with age five and above then what happens to the children below the 5 years if there is any delay then it will be considered as Global developmental delay that means you will use intellectual disability only for children five and above years now let's look into the screening Whenever there is a doubt with regard to education academics or understanding either the parents or the children or the teachers May complain about the children and the children may also be screened in the hospital or maybe in the school children in Search and sometimes will be seen in the OPD side that it may be Pediatrics or some other Clinic and then they need to be referred to pediatrician the pediatrician will look into the various neurological comorbidities and he will do the detailed assessment further he will look into whether the child has any visual difficulties locomotive difficulties or hearing difficulties why this is very essential imagine if the child is unable to see properly invariably it impairs his academics at the same time If the child is unable to hear properly again it will cause difficulty in answering questions hence the screening is very essential before we move for IQ assessment that means before you do IQ assessment you need to get the important clearance that the child does not have any eye related problem and hearing related problem now further the screening is divided into two the first one is for children between the age of 1 and 5 years in such a scenario where there is a delay vsms should be used that means vsms profiling has to be done and if there is any delay that is impairment in more than two domains equal or more than two domains then it will be considered as Global developmental delay for the child equivalent to five and above will be used either vsms or bkt or miics will be used here the intellectual disability will be the definition and finally irrespective of the age we will be using sity assessment of vsms for knowing the percentage I'll be discussing about vsms score and the disability percentage that means my dear friends you have to be very clear whether you are dealing with a child less than 5 years or more than 5 years if you are dealing with a child less than 5 years then you are going to use vsms which is there in appendix 6 unfortunately that appendix 6 is only a three line which has been mentioned these childrens who have at least two or more domain if there is a delay then we will consider AS Global developmental delay below the age of 5 years a temporary certificate has to be issued telling that the child has Global developmental delay this certificate is valid up to the age of 5 years once the child crosses 5 years years or else the first time the child reports maybe at the age of 5 years or more than 5 years then you'll be using various tools to assess the tools which can be used for adaptive functioning and IQ may be vsms again bamat test for intelligence wers intelligence scale for children Malin intelligence scale for Indian children National Institute for empowerment of persons with intellectual disability will be used again here the 7 8 ABC has been mentioned the certificate which is issued at the age of five If the child has more than 80% disability in such a scenario the certificate used or issued at the age of 5 years that means the reassessment and recertification will be done only at the age of 18 years once it is done at the age of 18 or more that will be valid for the lifetime that means if the child has more than 80% If the child has less than 80% disability in such a scenario if the assessment is done at the age of 5 years it has to be redone at the age of 10 years and again at the age of 18 years once the assessment is done at the age of 18 or more that will be valid for Lifetime if you look at the disability calculation irrespective of the age the disability calculation will be done based on the vsms score that means the other test what we are using will be used to conquer the diagnosis if the vsms score is between 0 to 20 it will be considered as profound and 100% disability will be given If the child scores the vsms score between 21 to 35 then it will be considered severe and the disability will be 90% If the child scores between 36 to 54 then it will be considered as moderate and 75% disability will be given If the child score somewhere between 55 to 69 it will be considered as mild and 50% disability will be given If the child somewhere scores between 70 to 84 it will be considered as borderline and the 25% that means if their 25% is given the child will not get any benefit because the 40% is minimum has to be scored for social welfare measures now the question is who will be involved in the assessment there are four important peoples who will be involved one is the chairperson the chairperson shall be at the government official you will be the medical superent or the chief medical officer or civil surgeon the rest the pediatrician and or the pediatric neurologist if they are in the government fine or else they can be summoned from the private further the psychiatrist or the Child and Adolescent psychiatrist if they're in the government fine or else they can be hired from the private similarly clinical and Rehab psychologist this notification is very flexible with regard to having the chairperson being from the government and rest can be hired because as we know these pediatric neurologist pediatrician Child and Adolescent psychiatrist and psychiatrist are very R species in India that means they are very difficult to be found in the government sector invariably they have been working in the tertiary centers that means issuing certificate at the community health center taluka level and District level is very difficult to get the assessment done now let's critique about this gizette notification yes this gazet notification has been very clear and they have listed all the tools which can be used for IQ assessment they have clearly mentioned which are free tools and which are copyrighted tools they have given the permission to onboard private psychiatrist or child and adolesent psychiatrist except the chairman that means it is a very uh Progressive thinking in terms of helping the patient who has intellectual disability and many time they have to come multiple times to get the assessment done if you go to tery centers invariably the waiting period is somewhere 6 months to one year that means that is the uh things which is happening at metropolitan cities what about the district hospitals many a time they do not have the tool or else they are unable to assess because they are not being trained further invariably they have mentioned about vsms is mandatory for assessing the disability unfortunately it is a copyrighted one who is going to buy is it the government servant or else the charges will be on the patient please understand right to persons with Disability Act of 2016 is a rights based which is claimed against the state that means the state has to buy the copyrighted version of vsms and and train the psychologist who are working in dmhp that means my dear friend this copyrighted version has to be brought by the state government invariably vsms has been mandatory not only that for qualified person in the medical Authority is unreasonable according to me earlier PWD act required only three people now you have made four specialist to be there and by chance if they are not a aable in certain States especially maybe Northeastern states clinical psychologist may not be there psychiatrists may not be there in all the districts that means they have to come to the capital city to get the IQ assessment done and they have to travel five to 10 times to get the certificate that means are we talking about a right to persons with Disability Act or else a charity which is done by the state that means we should understand what is the ground reality and we have to write this Gaz that notification Unfortunately they also mentioned about three assessments which have to be done by different people is not required not only that if a person is scoring less than 80% he has to get assessment at the age of five 10 years and 18 years that means already getting one IQ test is very difficult you are asking for three tests is unwanted unwarranted if the IQ test is done at the age of 18 and above that can be valid for life unfortunately the reality is not being kept in mind three assessments is not required if you look at the page number 532 appendix 6 talked about VSS SMS but it is a copyright head that means they have mentioned the user may follow the due process what does it mean that means the person who is assessing has to buy this or else will the state do it that's the question which is a I doar one similarly Mal intelligence scale for Indian children is also a copyrighted one similarly V scale for children that means whoever is going to do that means their users may follow the due process is the word has been used even for bam finally we have to use only nap ID IQ test wish they would have told only nip ID IQ test telling that it is freely avable that can be used rather than giving the list which are copyrighted to conclude my dear friend the gazed notification appears to be very good at the same time it is 800 pages and anybody especially even the professional finds it difficult to find where is disability assessment for IQ where is the appendix which are those scales and some of them are copyrighted some of them are free and for the copyrighted version who is going to buy that has to be answered by the state training of the government District mental health program officer has to be done at the earliest the committee never considered availability of resources for assessment especially with regard to git notification thank you very much for giving your valuable time stay safe [Music]